title: [The health-related quality of life and bio-psycho-social adaptation effects in patients with head and neck cancer: a longitudinal study].
abstract: BACKGROUND
  Because of the therapies and methods involved in its treatment, head and neck cancer patients often face unpredictable changes in both quality of life (QoL) and psychological status over the long course of their disease. Most studies have used fixed-term measurements that do not consider time variance and its effects. To facilitate medical communication and rehabilitation interventions, we investigated changes in HNC (head and neck cancer) patients' bio-psycho-social status and QoL over time.
  
  
  OBJECTIVE
  This study examines QoL growth patterns and the bio-psycho-social adaptation effect in HNC patients as well as how various variables affect within-individual and between-individual level factors during the 4 stages of HNC.
  
  
  METHODS
  A total of 109 HNC patients participated in this study. Two hundred and fifty-seven valid questionnaires were gathered. Questionnaires were given to each patient at 4 times: initial disease diagnosis; during the therapy period; 3 months after therapy; and 6 months after therapy. Descriptive statistics and hierarchical linear models were used in data analysis.
  
  
  RESULTS
  The main results revealed that: (1) degree of mood disturbance decreased linearly as illness stage progressed. Age, gender, religion, and job impacted patients' initial status, while gender, cancer stage, and education degree were significant moderators of the rate at which a participant's adaptation effect grew; (2) patient QoL showed no significant difference over time. Age and job were significant impact factors affecting patients' initial status. Cancer stage, educational degree, and marital status had a significant moderating effect on the growth rate of participants' adaptation effect score.
  
  
  CONCLUSIONS
  Our results indicate that participants in this study had a higher level of anxiety and depression than the average population and that their QoL was negatively influenced by the side effects of their therapy. Therefore, study findings recommend that timely psycho-social intervention and side-effect education should be reinforced to enhance patients' quality of life.
authors.affiliation: Department of Early Childhood Care and Education, Taoyuan Innovation Institute of Technology, Taiwan, ROC. hc_yang127@yahoo.com.tw.
authors.forename: Hui-Ching
authors.initials: HC
authors.lastname: Yang
authors.forename: Li-Fei
authors.initials: LF
authors.lastname: Wang
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
authors.forename: Fumin
authors.initials: F
authors.lastname: Fang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012917:Social Adjustment
keywords: bio-psycho-social adaptation; head and neck cancer; health-related quality of life; hierarchical linear modeling (HLM)